NIGERIA’S fragile healthcare system continues to face renewed strain as the Coordinating Minister of Health and Social Welfare, Muhammad Ali Pate, disclosed that only ₦36 million was released from the ₦218 billion approved for the ministry’s 2025 capital projects.
Pate made the revelation on Monday, February 9,in Abuja during the ministry’s 2026 budget defence before the House of Representatives Committee on Healthcare Services, explaining that the severe funding shortfall stalled the implementation of critical health projects nationwide.
“Out of the N218 billion appropriated to the health sector by the parliament for the execution of capital projects in the 2025 fiscal year, only N36 million was released,” Pate said.
According to the minister, while the personnel allocation for 2025 was fully released and utilised, the capital component was unavailable.
He said this was due to the federal government’s bottom-up cash planning system, which constrained access to project funds.
He further noted that delays in releasing Nigeria’s counterpart contributions prevented the ministry from drawing down donor-supported financing tied to key health interventions, compounding the inability to execute planned projects.
Pate said the sector’s programmes were guided by national development frameworks such as Vision 20:2020, the National Development Plan 2021–2025, and the National Strategic Health Development Plan II.
He added that the frameworks were aimed at strengthening healthcare delivery and expanding access, particularly through primary healthcare and universal health coverage.
“The principles of universal health coverage are central to the national health policy objective of strengthening Nigeria’s health system, particularly the primary health care subsystem, to deliver quality, effective, efficient, equitable, accessible, affordable, acceptable and comprehensive health services to all Nigerians,” he said.
The ICIR reports that despite these policy commitments, the near absence of capital releases in 2025 reflected how millions of Nigerians have continued to face limited access to health infrastructure and essential services.
This also raised fresh questions about the government’s ability to translate health budgets into meeting citizens’ needs.
This was despite the very low budget five per cent allocation of the national budget to the sector in the 2025 appropriation act, which fell short of the Abuja declaration.
Long history of weak capital spending
The latest shortfall reflects a long-standing structural pattern in Nigeria’s health financing, where most public spending goes to salaries and other overhead costs rather than building, refurbishing hospitals and equipping them.
The ICIR investigation had in 2022 shown that government budget data showed that between 2011 and 2021, Nigeria spent about 72 percent of its health budgets on recurrent expenditure – paying salaries, training workers and running offices – leaving only a small fraction for capital projects such as building and equipping health facilities.
Within the same period, although roughly ₦640 billion was earmarked for capital investment, less than 80 percent of that amount was released, further weakening infrastructure development across the sector.
This imbalance has persisted for years with health allocations also remaining far below the 15 per cent benchmark that African leaders agreed to provide in what is widely known as Abuja Declaration, with Nigeria often committing below eight per cent of its national budget to health since the declaration.
Recall that in January 2025, Pate also disclosed that only 15.06 per cent of the 2024 ministry’s capital allocation was released, despite billions earmarked for infrastructure and services.
Sector under severe strain
Nigeria, with a population nearing 250 million, continues to face deep structural challenges in healthcare delivery despite modest progress in recent years.
Out-of-pocket spending accounts for about 74.68 per cent of total health financing, placing a heavy burden on households and limiting access to essential services. Neonatal mortality remains high at 41 deaths per 1,000 live births as of 2023, while the maternal mortality rate of 576 deaths per 100,000 live births ranks among the worst globally.
The system is also critically understaffed, with about 55,000 licensed doctors serving the population as of March 2024.
The ICIR reports that inequitable distribution of services, weak infrastructure, persistent brain drain and widening socioeconomic inequalities, particularly in rural and underserved communities, have continued to deepen health disparities.
Many facilities lack basic equipment, medicines and essential amenities, while poor remuneration and working conditions drive the continued emigration of skilled health professionals, further weakening service delivery.
At different times, recurring strikes have crippled services in public hospitals because of workers-government face-offs over pay and other demands.
Mustapha Usman is an investigative journalist with the International Centre for Investigative Reporting. You can easily reach him via: musman@icirnigeria.com. He tweets @UsmanMustapha_M